Individual provider Active NPI

Jenna N Treadwell, NP

  • Gerontology Nurse Practitioner
  • Greenwood, IN
National Provider Identifier
1548611346
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71006323A Issued in IN
Practice address
701 E County Line Rd Ste 101
Greenwood, IN 46143-1070
Phone
(317) 885-2860
Fax
(317) 885-2869
NPI assigned
Jun 23, 2016
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 28178949A IN
Gerontology Nurse Practitioner 363LG0600X 71006323A IN Primary

Addresses

Primary practice location

701 E County Line Rd Ste 101
Greenwood, IN 46143-1070

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1801 N Senate Blvd Ste 230
Indianapolis, IN 46202-1252
Phone (317) 962-5280

Other practice location 2

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other identifiers 1

IdentifierTypeStateIssuer
201381360MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct.indianainternalmedicine@ccme.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160812001032 IN Practitioner - Nurse Practitioner 7214221324 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana Medical College, School of Medicine of Purdue University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiothoracic Surgeons IncGroup PAC ID 8729033964, 66 clinicians
St Francis Medical Group LLCGroup PAC ID 7012067697, 113 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 962-2000

701 E County Line Rd
Suite 101
Greenwood, IN 46143-1070
Phone (317) 885-2860

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Medical Group LLC CurrentSince Oct 4, 2021 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Indiana Clinic Critical Care LLC CurrentSince Sep 12, 2016 Accepting new patients
St. Francis Medical Group, LLC Acute Care CurrentSince Oct 4, 2021 Accepting new patients
Indiana Internal Medicine Consultants, LLC. Acute Care CurrentSince Oct 4, 2021 Accepting new patients
Cardiothoracic Surgeons Inc. CurrentSince Jan 12, 2021 Accepting new patients

Locations

2574 Reliable Pkwy
Chicago, IL 60686

701 E County Line Rd
Ste 101
Greenwood, IN 46143
Phone (317) 885-2860

1633 N Capitol Ave
Ste 301
Indianapolis, IN 46202
Phone (317) 963-0601

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1801 Senate Blvd
Ste 230
Indianapolis, IN 46202
Phone (317) 962-5280

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

545 Barnhill Dr
#215
Indianapolis, IN 46202
Phone (317) 274-7949

Interoperability endpoints

  • Direct secure messaging: direct.indianainternalmedicine@ccme.com
  • Direct secure messaging: jtreadwell601464@direct.franciscanalliance.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1548611346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E COUNTY LINE RD STE 101",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431070",
            "telephone_number": "317-885-2860",
            "fax_number": "317-885-2869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 N Senate Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021252",
            "country_code": "US",
            "telephone_number": "317-962-5280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREADWELL",
        "first_name": "JENNA",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "28178949A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71006323A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201381360",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct.indianainternalmedicine@ccme.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 E County Line Rd Ste 101",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.